Connecticut 2025 Regular Session

Connecticut Senate Bill SB01299 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1
2	2
3		-	LCO 4402 1 of 4
	3	+	LCO No. 4402 1 of 5
4	4
5	5		General Assembly Raised Bill No. 1299
6	6		January Session, 2025
7	7		LCO No. 4402
8	8
9	9
10	10		Referred to Committee on HUMAN SERVICES
11	11
12	12
13	13		Introduced by:
14	14		(HS)
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	16	+
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17	19		AN ACT CONCERNING MEDICAID -COVERED DENTAL CARE.
18	20		Be it enacted by the Senate and House of Representatives in General
19	21		Assembly convened:
20	22
21	23		Section 1. Section 17b-282c of the general statutes is repealed and the 1
22	24		following is substituted in lieu thereof (Effective July 1, 2025): 2
23	25		(a) All nonemergency dental services provided under the 3
24	26		Department of Social Services' dental programs, as described in section 4
25	27		17b-282b, shall be subject to prior authorization. Nonemergency 5
26	28		services that are exempt from the prior authorization process shall 6
27	29		include diagnostic, prevention, basic restoration procedures and 7
28	30		nonsurgical extractions that are consistent with standard and reasonable 8
29	31		dental practices. Payment for nonemergency dental services shall not 9
30	32		exceed one thousand dollars per calendar year for an individual adult, 10
31	33		provided prevention services such as oral exams and dental cleanings 11
32	34		and services determined to be medically necessary, as defined in section 12
33	35		17b-259b, including dentures, shall not be subject to such payment cap. 13
34	36		Dental benefit limitations shall apply to each client regardless of the 14
35	37		number of providers serving the client. The commissioner may recoup 15
36	38		payments for services that are determined not to be for an emergency 16
37		-	~~condition or otherwise in excess of what is medically necessary. The 17~~ Raised Bill No. 1299
	39	+	Raised Bill No. 1299
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39	41
40		-	LCO 4402 2 of 4
41	42
	43	+	LCO No. 4402 2 of 5
	44	+
	45	+	condition or otherwise in excess of what is medically necessary. The 17
42	46		commissioner shall periodically, but not less than quarterly, review 18
43	47		payments for emergency dental services and basic restoration 19
44	48		procedures for appropriateness of payment. For the purposes of this 20
45	49		section, "emergency condition" means a dental condition manifesting 21
46	50		itself by acute symptoms of sufficient severity, including severe pain, 22
47	51		such that a prudent layperson, who possesses an average knowledge of 23
48	52		health and medicine, could reasonably expect the absence of immediate 24
49	53		dental attention to result in placing the health of the individual, or with 25
50	54		respect to a pregnant woman, the health of the woman or her unborn 26
51	55		child, in serious jeopardy, cause serious impairment to body functions 27
52	56		or cause serious dysfunction of any body organ or part. 28
53	57		(b) The Commissioner of Social Services may implement policies and 29
54	58		procedures necessary to administer the provisions of this section while 30
55	59		in the process of adopting such policies and procedures as regulation, 31
56	60		provided the commissioner [prints] posts notice of intent to adopt 32
57	61		regulations [in] on the [Connecticut Law Journal] eRegulations System 33
58	62		not later than twenty days after the date of implementation. Policies and 34
59	63		procedures implemented pursuant to this section shall be valid until the 35
60	64		time final regulations are adopted. 36
61	65		Sec. 2. Section 17b-282d of the general statutes is repealed and the 37
62	66		following is substituted in lieu thereof (Effective July 1, 2025): 38
63	67		(a) The Commissioner of Social Services shall modify the extent of 39
64	68		nonemergency adult dental services provided under the Medicaid 40
65	69		program. Such modifications shall include, but are not limited to, 41
66	70		providing one periodic dental exam, [one dental cleaning] two dental 42
67	71		cleanings, periodontal therapy and one set of bitewing x-rays each year 43
68	72		for a healthy adult. For purposes of this section, "healthy adult" means 44
69	73		a person twenty-one years of age or older for whom there is no evidence 45
70	74		indicating that dental disease is an aggravating factor for the person's 46
71	75		overall health condition. 47
72		-	(b) The commissioner may implement policies and procedures 48
73		-	necessary to administer the provisions of this section while in the 49 Raised Bill No. 1299
	76	+	Raised Bill No. 1299
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75	78
76		-	LCO 4402 3 of 4
77	79
	80	+	LCO No. 4402 3 of 5
	81	+
	82	+	(b) The commissioner may implement policies and procedures 48
	83	+	necessary to administer the provisions of this section while in the 49
78	84		process of adopting such policies and procedures in regulation form, 50
79	85		provided the commissioner [prints] posts notice of intent to adopt 51
80	86		regulations [in] on the [Connecticut Law Journal] eRegulations System 52
81	87		not later than twenty days after the date of implementation. [Such 53
82	88		policies and procedures shall remain valid for three years following the 54
83	89		date of publication in the Connecticut Law Journal unless otherwise 55
84	90		provided for by the General Assembly. Notwithstanding the time 56
85	91		frames established in subsection (c) of section 17b-10, the commissioner 57
86	92		shall submit such policies and procedures in proposed regulation form 58
87	93		to the legislative regulation review committee not later than three years 59
88	94		following the date of publication of its intent to adopt regulations as 60
89	95		provided for in this subsection. In the event that the commissioner is 61
90	96		unable to submit proposed regulations prior to the expiration of the 62
91	97		three-year time period as provided for in this subsection, the 63
92	98		commissioner shall submit written notice, not later than thirty-five days 64
93	99		prior to the date of expiration of such time period, to the legislative 65
94	100		regulation review committee and the joint standing committees of the 66
95	101		General Assembly having cognizance of matters relating to human 67
96	102		services and appropriations and the budgets of state agencies indicating 68
97	103		that the department will not be able to submit the proposed regulations 69
98	104		on or before such date and shall include in such notice (1) the reasons 70
99	105		why the department will not submit the proposed regulations by such 71
100	106		date, and (2) the date by which the department will submit the proposed 72
101	107		regulations. The legislative regulation review committee may require 73
102	108		the department to appear before the committee at a time prescribed by 74
103	109		the committee to further explain such reasons and to respond to any 75
104	110		questions by the committee about the policy. The legislative regulation 76
105	111		review committee may request the joint standing committee of the 77
106	112		General Assembly having cognizance of matters relating to human 78
107	113		services to review the department's policy, the department's reasons for 79
108	114		not submitting the proposed regulations by the date specified in this 80
109	115		section and the date by which the department will submit the proposed 81
	116	+	Raised Bill No. 1299
	117	+
	118	+
	119	+
	120	+	LCO No. 4402 4 of 5
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110	122		regulations. Said joint standing committee may review the policy, such 82
111	123		reasons and such date, may schedule a hearing thereon and may make 83
112		-	a recommendation to the legislative regulation review committee.] 84 Raised Bill No. 1299
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114		-
115		-	LCO 4402 4 of 4
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	124	+	a recommendation to the legislative regulation review committee.] 84
117	125		Sec. 3. (NEW) (Effective July 1, 2025) (a) As used in this section, (1) 85
118	126		"mobile dental clinic" has the same meaning as provided in section 17b-86
119	127		282f of the general statutes, and (2) "school-based health center" and 87
120	128		"expanded school health site" have the same meanings as provided in 88
121	129		section 19a-6r of the general statutes. 89
122	130		(b) The Commissioner of Social Services shall not require that 90
123	131		separate dental services and procedures be provided to a patient in a 91
124	132		single visit as a condition of Medicaid payment for Medicaid-eligible 92
125	133		dental services or treatment provided at a mobile dental clinic, school-93
126	134		based health center or expanded school health site. The commissioner 94
127	135		shall provide Medicaid payment for each Medicaid-eligible service and 95
128	136		procedure separately billed and not require that reimbursement be 96
129	137		provided through a bundled payment methodology that provides one 97
130	138		aggregate payment for separate dental services and procedures. The 98
131	139		commissioner shall, in accordance with the provisions of chapter 54 of 99
132	140		the general statutes, adopt regulations to implement the provisions of 100
133	141		this section. The commissioner may implement policies and procedures 101
134	142		necessary to administer the provisions of this section while in the 102
135	143		process of adopting such policies and procedures as regulation, 103
136	144		provided the commissioner posts notice of intent to adopt regulations 104
137	145		on the eRegulations System not later than twenty days after the date of 105
138	146		implementation. Policies and procedures implemented pursuant to this 106
139	147		section shall be valid until the time final regulations are adopted. 107
140	148		This act shall take effect as follows and shall amend the following
141	149		sections:
142	150
143	151		Section 1 July 1, 2025 17b-282c
144	152		Sec. 2 July 1, 2025 17b-282d
145	153		Sec. 3 July 1, 2025 New section
146	154
147		-	HS Joint Favorable
	155	+	Raised Bill No. 1299
	156	+
	157	+
	158	+
	159	+	LCO No. 4402 5 of 5
	160	+
	161	+	Statement of Purpose:
	162	+	To expand preventive adult oral health services covered under
	163	+	Medicaid and require that Medicaid payment be made for eligible
	164	+	dental services and procedures at mobile dental clinics and school-based
	165	+	health centers and sites without requiring such services or procedures
	166	+	be provided in a single visit.
	167	+
	168	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	169	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	170	+	underlined.]
148	171